ИСТИНА

Early non-invasive diagnostics of the endometriosis in adolescents presents great difficulties. The purpose of this study is to compare MRI with laparoscopy. Methods: A total of 60 girls (from menarche to 17 years old) were included in the case-control study. Results: Two groups were identified according to the MRI, in one of them endometriosis was accurately verified (n=15) and in other indirect signs of this process were revealed (n=27). The following signs were highlighted to accurately verifying the diagnosis: compaction of the ovarian capsule (53%, 8/15), thickening of the sacro-uterine ligament (47%, 7/15), hypointensive foci in the pelvic fat (40%, 6/15), heterogeneity of the parametric tissue (47%, 7/15), paraovarian tissue (27%, 4/15), endometrioid lesion of the uterine serous cover (47%, 7/15), heterogeneous signal from ovarian stroma (33%, 5/15), hypointensive foci in the Douglas space (13%, 2/15), heterogeneity of the paracervical fat (13%, 2/15). A concomitant lesion of the sacro-uterine ligaments and pelvic fat was found in 67% (10/15). MRI and laparoscopy imaging results were almost consistent for the foci of the parametric fat and retrocervical region (47%, 7/15 and 47%, 7/15), paraovarian fat and peritoneum of the ovarian fossa (27%, 4/15 and 47%, 7/15), paracervical fat and peritoneum of the cervix (13%, 2/15 and 7%, 1/15). In contrast false positive results were more likely for the ovarian capsule (8 cases out of 2), pelvic peritoneum (6 cases out of 3) according to MRI. Indirect signs were described in most cases, when endometriod lesion was suspected, they include heterogeneity of the sacro-uterine ligaments (56%, 13/27), pelvic peritoneum (44%, 12/27), paraovarian fat (56%, 13/27), parametric fat (63%, 17/27), serous uterine cover (19%, 5/27), paracervical fat (11%, 3/27), heterogeneous signal from the ovaries stroma (37%, 10/27), Douglas space (15%, 4/27). Concomitant heterogeneity of the pelvic peritoneum and sacro-uterine ligaments was found in 85% (22/27) of patients. MRI and laparoscopy imaging results were virtually identical for the paraovarian fat and ovarian fossa peritoneum (56%, 13/27 and 44%, 12/27), concomitant sacro-uterine ligaments lesions and pelvic peritoneum (85%, 23/27 and 85%, 23/27). False positive results were more specific to the ovarian stroma (10 cases out of 3), parametric fat (17 cases out of 3) according to MRI. Conclusion: 25% of patients (15/60) were accurately diagnosed with PE, 45% (27/60) had indirect signs of the pathological process and in 30% (18/60) MRI cases did not reveal endometrioid lesion of the peritoneum.